Background HIV-infected youth are at risk of hepatitis B (HBV) infection and should be vaccinated. Previous reports suggest reduced response to standard HBV vaccine regimens. Methods HIV-infected youth, age 12 to <25 years, were randomly assigned to one of three treatment arms: Arm 1: Engerix B ® , 20 mcg HBsAg; Arm 2: Engerix B ® , 40 mcg; and Arm 3: Twinrix ® , 20mcg HBsAg combined with 720 ELU hepatitis A antigen. Vaccines were administered at weeks 0, 4 and 24. Results Characteristics of evaluable patients (n=336) at entry were similar in the study arms. At enrollment, median CD4+ T-cell count was 460 cells/mm 3 (IQR: 305 to 668); 13% were < 200 cells/mm 3 . Among Engerix B ® , 20 mcg recipients, 60.4% responded to vaccine (HBsAb ≥ 10 IU/mL at week 28). Improved vaccine response was seen in recipients of Engerix B ® , 40 mcg, (73.2%, vs. Arm 1, p=0.04) and Twinrix ® (75.4%, vs. Arm 1, p=0.02). In multivariate analysis, only baseline CD4+ T-cell count and study arm were independent predictors of vaccine response. Conclusions In HIV-infected youth, a three dose vaccination regimen with Engerix B ® , 40 mcg, or Twinrix ® and higher baseline CD4+ T-cell counts were independently associated with improved vaccine response.
【저자키워드】 HIV, adolescents, Hepatitis B vaccination, Twinrix, Engerix B,